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Healthcare Claims Team Lead
Imagenet LLCHealthcare Claims Team Lead overseeing client implementation and operational readiness. Engaging in process design and team leadership within healthcare claims operations.
About the role
Key responsibilities & impact- Lead end-to-end client implementation, from discovery through go-live and stabilization
- Translate client requirements into operational workflows, SOPs, and staffing models
- Develop and execute detailed implementation plans, including timelines and milestones
- Identify risks early and proactively drive mitigation strategies
- Partner with Training, QA, IT, and Workforce Management teams to ensure readiness across all workstreams
- Coordinate system setup, user acceptance testing (UAT), and access provisioning with IT and client teams
- Ensure all systems, tools, and environments are fully tested and production-ready prior to go-live
- Support development of process documentation, job aids, and knowledge base materials
- Validate workflows for claims processing, including escalation paths and exception handling
- Ensure processes are scalable, efficient, and aligned with client expectations
- Perform standard Team Lead responsibilities including team oversight, performance management, and reporting
- Take ownership of Quality Assurance and Training functions during the implementation phase
- Provide hands-on support in building, testing, and executing processes
Requirements
What you’ll need- Min. 5 years of experience processing easy, moderate, and complex medical claims (payer-side experience preferred)
- 2+ years in a leadership role within claims or healthcare operations.
- Proven experience in implementations, transitions, or new client launches
- Strong experience with Medicare and Medi-Cal claims, including a working knowledge of CMS guidelines and regulatory requirements.
- Prior quality assurance and training experience with demonstrated ability to identify trends
- Previous experience leading, coaching, or mentoring teams in a claims or healthcare operations environment.
- Strong analytical skills with the ability to interpret performance data and KPIs.
- Excellent communication, organizational, and decision-making skills.
- High attention to detail and commitment to accuracy, compliance, and operational excellence.
Benefits
Comp & perks- Remote work offered
- Equipment provided
- Paid training to set you up for success
- Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingimplementation planninguser acceptance testingprocess documentationperformance managementquality assurancedata interpretationKPI analysisrisk mitigationworkflow validation
Soft Skills
leadershipcommunicationorganizational skillsdecision-makinganalytical skillsattention to detailcoachingmentoringteam oversightcommitment to accuracy